The best counties to live in based on life expectancy, poverty and access to basic services

For a longer life move to Laikipia, but for quality healthcare and prosperity Nairobi is the place to be

Nairobi is the best county to live in based on life expectancy, security, poverty rate, standard of living, access to credit, access to healthcare, education performance and families experiencing adverse events, reveals a NationNewsplex review of economic and well-being data.

The capital city led in three of the eight categories, including access to healthcare, poverty rate and GCP per capita. The county has the highest rate of health professionals (doctors, clinical officers and nurses), with 148 health workers per 100,000 people, the lowest poverty rate of 17 percent, and the highest GCP per capita, a measure of a county’s standard of living, of Sh212,498.

The rate of health workers was used as an indicator of access to healthcare.

''Functions like security, education (save for early childhood education), and the likes are not under the control of county governments. They can only appeal to the national government through their representatives in the legislature so that more resources can be channelled to such areas,'' says Mr Kwame Owino, chief executive officer of the Institute of Economic Affairs (IEA-Kenya).

Turkana had the lowest number of health professionals per 100,000 people (10) and the highest poverty rate of 79 percent, while Mandera had the smallest GCP per capita of Sh28,602.

In second place overall was Mombasa, which did particularly well in GCP per capita and rate of families not experiencing shocks, ranking in position two in both indicators. A shock is an event that triggers a decline in a family’s welfare.

In third place was Elgeyo-Marakwet, which stayed close to the top in five of the eight categories and hence ranking third overall. Its highest category ranking was third place, twice, in education performance and access to credit. It came fifth in GCP per capita. It was, however, weighed down by a relatively high crime rate, poverty level and a low life expectancy in which it ranked position 17, 32 and 21, respectively.

The NationNewsplex analysis is based on data from the Economic Survey 2018, Gross County Product 2019, Kenya Integrated Household Budget Survey (KIHBS) 2015/2016 and the Statistical Review of Progress Towards the Mid-Term Targets of the Health Sector Strategic Plan 2014-2018. Points were awarded to counties under the eight indicators and a total of each county’s scores calculated.

Nairobi lost points on security, education performance and access to credit.

In 2017, when police released the latest full-year crime rates by county, Nairobi registered 163 reported crime incidents per 100,000 people, putting it at number 26 on security ratings in which Mandera emerged first with 43 cases per 100,000 people and Meru last, with 347 cases per 100,000 people.

Education performance

In education, indicated by Kenya Certificate of Secondary Education examination (KCSE) performance, the county’s mean grade of D+ put it a distant position 27, behind leader West Pokot, which had a C (plain). The Newsplex analysis considered the average of each county’s mean scores in 2014-2016 KCSE results. Tana River was bottom with a D.

Nairobi is also ranked low in access to credit, coming at position 31 with an access rate of 89 percent. The rate at which people successfully sought credit in the 12 months preceding the Kenya Integrated Household Budget Survey (KIHBS), 2015/2016, was highest in Makueni County, at 99 percent.

The survey defines credit as money or goods advanced to a household member or members by an individual, organisation or a financial institution in kind or cash, with an arrangement to repay later, usually at a cost. All sources of credit to households were considered, including informal ones such as friends, relatives or local money lenders or shylocks.

On this indicator, Marsabit County was last with 34 percent.

Others in the top 10 best counties to live in are Nyeri, at number four, followed by Kiambu, Bomet, Uasin Gishu, Kericho, Nakuru and Kirinyaga.

Half of the top 10 counties are from the Rift Valley, making it the dominant region at the top.

Missed out

Five out of the top 10 richest counties, based on GCP, were not in the best 10 counties to live in. They are Nyandarua, at number 11, Kisumu (13), Machakos (14), Kakamega (25) and Meru (34).

GCP is the monetary value of all the goods and services produced in a county within a specific period of time.

Kisumu was weighed down by low scores in medical professionals per 100,000 people and life expectancy, ranking 44 in each.

Meru came last in security and 37 in access to credit, while low rankings in life expectancy (41) and access to credit (32) contributed to Nyandarua missing a slot in the top 10.

Mr Kwame Owino, chief executive officer of the Institute of Economic Affairs (IEA-Kenya), says that counties can only do so much in terms of translating big economies into better living conditions as long as many of the indicators used to rank them are under the control of the national government. ''Functions like security, education (save for early childhood education), and the likes are not under the control of county governments. They can only appeal to the national government through their representatives in the legislature so that more resources can be channelled to such areas,'' he says.

Against all odds

Marsabit County emerged last, followed by Turkana, Samburu, Mandera and Kilifi. A high disparity in the poverty rate amongst counties seemed to disadvantage the counties that ended up at the bottom in the overall score. Out of the last five worst counties to live in, three led in poverty rate, the latest KIHBS data shows. Turkana had a poverty rate of 79 percent, the highest, followed by Mandera (78 percent) and Samburu (76 percent).

Mr Owino thinks that such counties with small economies are disadvantaged in many ways and that an external intervention like the equalisation fund would help improve living conditions and appeal.

However, many of the bottom 10 counties in GCP performed better in the list of the best counties to live in terms of the eight factors considered in the survey. Among the six is Lamu County, with the third-smallest economy, rising to number 28. Its main asset was a high ranking, at number seven, in GCP per capita.

Stood out

If you want to live well, live in Nairobi County. But if you want to live long, live in Laikipia County.

According to a study titled Health disparities across the counties of Kenya and implications for policy makers that was published in the Lancet, Laikipia has the highest life expectancy of 72 years followed by Uasin Gishu, Bomet and Kericho, tying with 71. Homa Bay has the lowest life expectancy of 57, followed by Migori (59) and Tana river (60).

Kiambu County emerged as the least prone to shocks, the KIHBS shows, implying a general sense of well-being of residents.

Households across the country reported experiencing different shocks, including loss of property, loss of crops and livestock, death or imprisonment of a breadwinner, fire tragedy and business failure.

The county had only 17 percent of households reporting having experienced a shock in the five years preceding the survey, compared with Kitui’s 96 percent, which was the highest.

The Kenya National Bureau of Statistics is expected to release a number of reports this year, including the 2019 census report, that will affect some of the counties’ scores under many of the indicators used in this analysis. For example, new figures on population and education levels will likely change the counties’ rankings.